Shelby Stewart / The (Louisville, Ky.) Courier-Journal

by Laura Ungar and Chris Kenning, The (Louisville, Ky.) Courier-Journal

by Laura Ungar and Chris Kenning, The (Louisville, Ky.) Courier-Journal

LOUISVILLE, Ky. -- The shocking story was one of many in the news linking suicide and murder - Gary W. Stewart of Louisville fatally shot his former girlfriend and their 8-year-old daughter before killing himself in June at his uncle's condo complex.

But mental health and justice experts say murder-suicides are the exception and that suicidal people are rarely a risk to others - even when mental illness is a factor in both.

Studies estimate 1,000 to 1,500 murder-suicides occur per year in the United States - equating to less than 3 percent of the 54,623 suicides and homicides that took place nationally in 2010.

"It captures so much attention. But it's a pretty rare event," said Tony Zipple, president and chief executive officer of Seven Counties Services. "I think of it as very atypical."

Sabrina Walsh, director of the Kentucky Violent Death Reporting System, pointed to a study she co-wrote in 2005 which found that, between 1998 and 2000, just 3.2 percent of suicides in Kentucky were preceded by a homicide.

She and other experts say perpetrators in murder-suicides share characteristics. The vast majority are men, and many have mental disorders.

Most use guns; some studies say firearms are used more than 90 percent of the time in murder-suicides. The events tend to be spurred by domestic disputes and custody battles, with the man killing his female partner and often harming children as well.

The National Institute of Justice concurs, saying common characteristics of murder-suicide in families include a history of domestic violence, access to a gun, threats and a history of poor mental health or substance abuse, especially alcohol. In most cases, the man shows possessive, obsessive and jealous behavior, and tensions generally build before he kills, institute experts say.

"People think the person feels regret and kills themselves," Walsh said. "But these tend to be very premeditated and are often very violent."

Zipple said impulsiveness and substance abuse "are pretty common features," and up to half of murder-suicides involve divorce. Zipple said that, while mental illness is common among perpetrators, serious psychosis is not; the man is more likely to be depressed. Mental illness is thought to be a factor in nine out of 10 suicides overall.

In Stewart's case, court documents said he suffered from mental illness and spent time in the psychiatric ward at University of Louisville Hospital and at Central State Hospital. Jim Wood, uncle of murder victim Jillian Wood and a police officer with the Louisville Metro Police Department, said he learned from Stewart's family that Stewart had schizophrenia, heard voices and had hallucinations, and had recently stopped taking his medications.

Jim Wood said he believes mental illness was a huge issue in the murder-suicide. He said Stewart also was abusing alcohol and street drugs in an attempt to self-medicate. He said access to guns also was an issue.

"I want to find out where Gary Stewart got his firearm - who owned it," Jim Wood said. "I am a gun owner. I very much enjoy shooting sports. And as a responsible gun owner, I know it's incumbent upon me to secure my inventory."

Past violence also hinted at problems to come. Jocelyn Wood, twin sister of Jillian Wood, has told The Courier-Journal that her sister and Stewart had a turbulent past, including protective orders Jillian Wood had taken out against him, although the two had been trying to work together in parenting their two children.

In addition to a criminal complaint in which Jillian Wood said that Stewart threatened to shoot her, Stewart was convicted in 2011 of assaulting a 19-year-old woman in the emergency room waiting area at a local hospital.

Stewart's life came to a violent end on June 19. In addition to killing Jillian Wood and their daughter Shelbi Stewart, Stewart also shot his mother, Martha Stewart, seriously injuring her. Then he took his own life.

Zipple said that, while "there's overlap" between suicide and murder-suicide, he agreed with other experts that the two types of violence are also very different.

Experts said when a loved one is suicidal, by far the biggest concern is that the person may harm himself. Although it can be difficult to predict when a murder-suicide may arise, they said it's far more likely no one else will be harmed.

"You (should) worry about the suicidal person, getting them help so they can stay alive," Zipple said.